Megaloblastic Anemia
“What is megaloblastic anemia and why does it occur?”
Classification of Morphological Anemia
Based on red cell size, hemoglobin content, and red cell indices.
Microcytic hypochromic: MCV, MCH, and MCHC are all reduced For Example. in iron deficiency anemia and certain non-iron deficiency anemias, i.e., sideroblastic anemia, thalassemia, and anemia of chronic disorders.
“Common challenges in diagnosing and managing megaloblastic anemia”
Normocytic normochromic: MCV, MCH, and MCHC are all normal, For Example. after acute blood loss, hemolytic anemias, bone marrow failure, and anemia of chronic disorders.
Macrocytic: MCV is raised, For Example. in megaloblastic anemia due to a deficiency of vitamin B12 and folic acid.
“Understanding the role of megaloblastic anemia in blood disorders”
Question 2. Describe in brief peripheral and bone marrow pictures of megaloblastic anemia.
Answer:
- Peripheral picture
- Red cells show anisopokilo cytosis with the presence of macrocytes and macro ovalocytes, i.e., large oval RBCs.
- Presence of Howell-Jolly bodies, i.e., Nuclear remnants left after the nucleus is extruded and Cabot rings (abnormal histone synthesis causes arginine-rich histone to accumulate as rings in red cells)
- Neutrophil hypersegmentation is seen, i.,e. greater than 5% of neutrophils with more than five lobes or the presence of at least one six-lobe cell.
“Importance of studying megaloblastic anemia for better healthcare outcomes”
- Bone marrow picture
- It shows megaloblastic hyperplasia. The nuclei of erythroblasts are large with fine and open sieve-like chromatin. Hemoglobinization of cytoplasm is of normal rate, while nuclear maturation lags behind that of cytoplasm. This is known as nuclear-cytoplasmic asynchrony.
- Giant metamyelocytes and stab form are seen.
- Megakaryocytes may be large and abnormal.
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